Sleep disturbance in people with anxiety or depressive disorders over 30 years, and the influence of personality disorder

Objectives Sleep disturbance is commonly reported by people with anxiety, depressive and personality disorders, but longitudinal studies exploring the interplay of the three with disturbed sleep have not previously been described. Methods In this study sleep disturbance was examined among 89 patients initially presenting with anxiety or depressive disorders who provided follow-up at 12 and 30 year timepoints in The Nottingham Study of Neurotic Disorder. Multiple regression models were used to identify factors most predictive of poor sleep, and changes in sleep quality over time. Results There were strong associations between poor sleep and contemporaneous severity of personality disorder and the presence of other mental disorders at 12 and 30 years follow-up, but not with disorder presence at other time points. Improvements in personality disorder were associated with improvements in sleep between time points, and attenuated the positive unadjusted effects of recovery from anxiety or depressive disorders to insignificance. Relapse into further episodes of mental disorder predicted poorer sleep, whereas worsening personality disorder was not predictive of significant changes when adjusting for other factors. Conclusions This study demonstrates the complex interplay between anxiety, depressive and personality disorders and sleep disturbance over a long follow-up period. Future research might look to examine the relationship between personality disorder and disturbed sleep with interventional studies and by integrating personality trait research.